Menu

Online Forms

Cheshire Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

To best address all your needs, all first time visitors are asked to fill out a Comprehensive Health Profile. This profile helps identify what areas need the most attention and what type of care would be the best fit for you.

Simply download the form, and fax it to us at: 603-357-5151 or bring it with you to your first appointment. Please email or call 603-357-5700 with any questions or comments to set up your first visit.

Download & Print Form



Download the Free Adobe Reader®

Interested in Becoming a New Patient? Give yourself or someone you love the Gift of Good Health!

Are You Feeling Lucky? March Special ONLY $105 (reg. $215) includes Consultation and Exam, Review of Findings, and Initial Session. Expires 4-1-19

Location

Find us on the map